Capillary refill time: the missing link between macrocirculation and microcirculation in septic shock?
Glenn Hernández, Ricardo Castro, Jan Bakker
Abstract
ANDROMEDA-SHOCK was a multicenter, randomized controlled trial comparing capillary refill time (CRT)- versus lactate-targeted resuscitation in patients with early septic shock (1). The protocol mandated sequential steps starting with fluid challenges, followed by vasoactive-related interventions if necessary, until the target was reached. CRT-targeted resuscitation was associated with lower mortality (34.9% vs. 43.4%; P=0.06), beneficial effects on organ dysfunction, and less treatment intensity. A strong survival benefit was also supported by a recently published post-hoc Bayesian analysis (2).
Topics & Concepts
MedicineSeptic shockMicrocirculationResuscitationCapillary refillEarly goal-directed therapyShock (circulatory)Organ dysfunctionIntensive care medicineRandomized controlled trialVasoactiveInotropePost-hoc analysisSepsisInternal medicineCardiologySevere sepsisAnesthesiaBlood pressureSepsis Diagnosis and TreatmentHemodynamic Monitoring and TherapyTrauma, Hemostasis, Coagulopathy, Resuscitation